The Participation Rates of Older Minority Persons in Community-Based Services in Long-Term Care.

Holmes, Monica; And Others

Existing data are summarized and original data provided on minority participation rates in alternative services among the elderly. Data from several federally-funded programs, including Medicare and Medicaid, are presented. A group of 32 counties in the US, representing a universe of counties in which minorities constitute a large proportion of the elderly population, are selected--four counties for each of the four minorities. Participation rates for minorities in health services, homemaker services, and daycare are reported for the 32 counties. Data analysis shows marked differences in minority access to services according to categorical funding programs. Medicare data in particular show that minorities are under-enrolled, and even those who are enrolled are less likely to use Medicare-reimbursed services than are whites. However, among those minorities who do use Medicare benefits, a higher proportion of minorities than whites use Part B for home health services. Similarly, the average per-person expenditure for home health benefits is more for minority than for white elderly. The data suggest unequal access for minorities and therefore a population of elderly who, when they finally get services, are sicker and require more services at greater cost. (Author)